, Volume 188, Issue 5, pp 393–399 | Cite as

Relationship Between Tobacco Consumption and Health-related Quality of Life in Adults Living in a Large Metropolitan Area

  • Javier de Miguel DíezEmail author
  • Maria Mercedes Esteban y Peña
  • Luis Puente Maestu
  • Valentín Hernández Barrera
  • Pilar Carrasco Garrido
  • Luis A. Alvarez-Sala Walther
  • Rodrigo Jiménez García


The aim of this study was to analyze the relationship between health-related quality of life (HRQOL) and tobacco consumption in adult individuals (over the age of 15). The study was based on individual data from the City of Madrid Health Survey (ESCM05). Subjects were divided into three groups according to tobacco consumption: smokers, nonsmokers, and ex-smokers. HRQOL was measured using the COOP/WONCA quality-of-life vignettes. A multivariate adjustment with multinomial logistic regression was made, including the following as covariables: sociodemographic characteristics, comorbidities, drug use, and lifestyles. A total of 7341 individuals were interviewed (53.7% women), with an average age of 46.7 (SD = 19.02) years. The percentage of smokers was 27%, that of ex-smokers was 16.5%, and that of nonsmokers was 56.5%. There were no significant differences between smokers, ex-smokers, and nonsmokers in the raw scores obtained as totals from the COOP/WONCA questionnaire. Multivariate analysis revealed that smokers consume more antidepressant drugs (OR = 1.54, 95% CI = 1.09–2.16) and tranquilizers (OR = 1.91, 95% CI = 1.45–2.51), drink more alcohol (OR = 2.55, 95% CI = 2.11–3.08), get less physical exercise (OR = 1.33, 95% CI = 1.11–1.60), and have a lower quality of life (OR = 1.02, 95% CI = 1.00–1.04) than nonsmokers. Following adjustment for a significant number of covariables, sociodemographic as well as health-related, smokers consume more antidepressant drugs and tranquilizers, drink more alcohol, get less physical exercise, and demonstrate a lower HRQOL than nonsmokers.


Tobacco Health-related quality of life Adults Psychoactive drugs 



The authors thank the Institute of Public Health of the City Council of Madrid for their cooperation in releasing data from the 2005 City of Madrid Survey.


  1. 1.
    Wald NJ, Hackshaw AK (1996) Cigarette smoking: an epidemiological overview. Br Med Bull 52:3–11PubMedGoogle Scholar
  2. 2.
    Doll R, Peto R, Wheatley K, Gray R, Sutherland I (1994) Mortality in relation to smoking: 40 years’ observations on male British doctors. BMJ 309:901–911PubMedGoogle Scholar
  3. 3.
    Peto R, Lopez AD, Boreham J, Thun M, Heath C (1998) Mortality from smoking in developed countries 1950–2000. Update to 1995 of analyses of mortality from smoking in 15 European Union countries. Oxford University Press, OxfordGoogle Scholar
  4. 4.
    De Miguel Díez J (2008) Consumo de tabaco y calidad de vida relacionada con la salud. Preb Tab 10:40–41Google Scholar
  5. 5.
    Carrasco Garrido P, de Miguel Díez J, Rejas Gutiérrez J, Centeno AM, Gobartt Vázquez E, Gil de Miguel A, García Carballo M, Jiménez García R (2006) Negative impact of chronic obstructive pulmonary disease on the health-related quality of life of patients. Results of the EPIDEPOC study. Health Qual Life Outcomes 4:31CrossRefPubMedGoogle Scholar
  6. 6.
    Unsar S, Sut N, Durna Z (2007) Health-related quality of life in patients with coronary artery disease. J Cardiovasc Nurs 22:501–507PubMedGoogle Scholar
  7. 7.
    Baddini Martinez JA, Assis Mota G, Oliveira Vianna SO, Terra Filho J, Alves Silva G, Luiz Rodrigues A (2004) Impaired quality of life of healthy young smokers. Chest 125:425–428CrossRefGoogle Scholar
  8. 8.
    Bellido Casado J, Martín Escudero JC, Dueñas Laita A (2008) On the use of the SF-36 Questionnaire to measure health-related quality of life in smokers. Arch Bronconeumol 44:176PubMedGoogle Scholar
  9. 9.
    Cayuela A, Rodríguez-Domínguez S, Otero R (2007) Deterioro de la calidad de vida relacionada con la salud em fumadores varones sanos. Arch Bronconeumol 43:59–63PubMedGoogle Scholar
  10. 10.
    Wilson D, Parsons J, Wakefield M (1999) The health-related quality-of-life of never smokers, and light, moderate, and heavy smokers. Prev Med 29:139–144CrossRefPubMedGoogle Scholar
  11. 11.
    Laaksonen M, Rahkonen O, Maritikainen P, Karnoven S, Lahelma E (2006) Smoking and SF-36 health functioning. Prev Med 42:206–209CrossRefPubMedGoogle Scholar
  12. 12.
    Bellido Casado J, Martín Escudero J, Dueñas Laita A, Mena Martín FJ, Arzúa Mouronte D, Simal-Blanco F (2004) The SF-36 questionnaire as a measurement of health-related quality of life: assessing short- and medium-term effects of exposure to tobacco versus the known long-term effects. Eur J Intern Med 15:511–517CrossRefPubMedGoogle Scholar
  13. 13.
    Encuesta de Salud de la Ciudad de Madrid, ESCM05. Available at Accessed 1 Sept 2009
  14. 14.
    Nelson E, Landgraf JM, Hays RD, Wasson JH, Kirk JW (1990) The functional status of patients. How can it be measured in physicians’ offices? Med Care 28:1111–1126CrossRefPubMedGoogle Scholar
  15. 15.
    Nelson EC, Wasson JH, Kirk JW (1987) Assessment of function in routine clinical practice. Description of the COOP chart method and preliminary findings. J Chronic Dis 40:55CrossRefGoogle Scholar
  16. 16.
    Scholten JGH, Van Weel C (1992) Functional status assessment in family practice. The Darmouth COOP Functional Health Assessment Charts/WONCA. Meditekst, LelystadGoogle Scholar
  17. 17.
    Lizán Tudela L, Reig Ferrer A (1999) Cross cultural adaptation of a health related quality of life measurement: the Spanish version of the COOP/WONCA cartoons. Aten Primaria 24:75–82PubMedGoogle Scholar
  18. 18.
    Strine TW, Okoro CA, Chapman DP, Balluz LS, Ford ES, Ajani UA, Mokdad AH (2005) Health-related quality of life and health risk behaviors among smokers. Am J Prev Med 28:182–187CrossRefPubMedGoogle Scholar
  19. 19.
    Bronnum-Hansen H, Juel K, Davidsen M, Sorensen J (2007) Impact of selected risk factors on quality-adjusted life expectancy in Denmark. Scand J Public Health 35:510–515CrossRefPubMedGoogle Scholar
  20. 20.
    Glassman AH (1993) Cigarette smoking: implications for psychiatric illness. Am J Psychiatry 150:546–553PubMedGoogle Scholar
  21. 21.
    Glassman AH, Helzer JE, Covey LS, Cottier LB, Steiner F, Tipp JE, Johnson J (1990) Smoking, smoking cessation, and major depression. JAMA 264:1546–1549CrossRefPubMedGoogle Scholar
  22. 22.
    Hughes JR, Hatsukami DK, Mitchell JE, Dahlgren LA (1986) Prevalence of smoking among psychiatric outpatients. Am J Psychiatry 143:993–997PubMedGoogle Scholar
  23. 23.
    De Leon J, Dadvand M, Canuso C, White AO, Stanilla JK, Simpson GM (1995) Schizophrenia and smoking: an epidemiological survey in a state hospital. Am J Psychiatry 152:453–455PubMedGoogle Scholar
  24. 24.
    Anda RF, Williamson DF, Escobedo LG, Mast EE, Giovino GA, Remington PL (1990) Depression and the dynamics of smoking: a national perspective. JAMA 264:1541–1545CrossRefPubMedGoogle Scholar
  25. 25.
    Son BK, Markovitz JH, Winders S, Smith D (1997) Smoking, nicotine dependence, and depressive symptoms in the CARDIA study: effects of educational status. Am J Epidemiol 145:110–116PubMedGoogle Scholar
  26. 26.
    Smichtz N, Kruse J, Kugler J (2003) Disabilities, quality of life, and mental disorders associated with smoking and nicotine dependence. Am J Psychiatry 160:1670–1676CrossRefGoogle Scholar
  27. 27.
    Mody RR, Smith MJ (2006) Smoking status and health-related quality of life: as findings from the 2001 Behavioral Risk Factor Surveillance System data. Am J Health Promot 20:251–258PubMedGoogle Scholar
  28. 28.
    Tillmann M, Silcock J (1997) A comparison of smokers’ and ex-smokers’ health-related quality of life. J Public Health Med 19:268–273PubMedGoogle Scholar
  29. 29.
    Grau A, Font-Mayolas S, Grãs MA, Suñer R, Noguera J (2007) Calidad de vida relacionada con la salud y consumo de tabaco. Intervención Psicosocial 16:79–92Google Scholar
  30. 30.
    Etter JF, Perneger TV (1999) Associations between the stages of change and the pros and cons of smoking in a longitudinal study of Swiss smokers. Addict Behav 24:419–424CrossRefPubMedGoogle Scholar
  31. 31.
    Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski W, Fiore C, Harlow LL, Redding CA, Rosenbloom D et al (1994) Stages of change and decisional balance for 12 problem behaviors. Health Psychol 13:39–46CrossRefPubMedGoogle Scholar
  32. 32.
    Chapman S, Wong WL, Smith W (1993) Self-exempting beliefs about smoking and health: differences between smokers and ex-smokers. Am J Public Health 83:215–219CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Javier de Miguel Díez
    • 1
    Email author
  • Maria Mercedes Esteban y Peña
    • 2
  • Luis Puente Maestu
    • 1
  • Valentín Hernández Barrera
    • 3
  • Pilar Carrasco Garrido
    • 3
  • Luis A. Alvarez-Sala Walther
    • 4
  • Rodrigo Jiménez García
    • 3
  1. 1.Pulmonology DepartmentHospital General Universitario Gregorio Marañón, Universidad Complutense de MadridMadridSpain
  2. 2.Public Health Institute—Madrid Salud, Madrid City CouncilMadridSpain
  3. 3.Teaching and Research Unit for Preventative Medicine and Public Health, Faculty of Health SciencesRey Juan Carlos UniversityAlcorcon, MadridSpain
  4. 4.Internal Medicine DepartmentHospital General Universitario Gregorio Marañón, Universidad Complutense de MadridMadridSpain

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